Some interesting poll results emerged at the end of last week, the biggest story from which being the Louisiana mass public still hasn’t quite shaken itself from its populist heritage, and the implications that could have for some future political careers.
Commissioned by the Louisiana State Medical Society, the data collected focus largely on views on health care issues. The group has a history of supporting policy decisions that maximize the flow of taxpayer dollars to state physicians, as evidenced (until it realized nothing could derail it) by its past initial opposition to Medicaid reform that became known as Bayou Health that scrutinizes more exactly doctors’ billing requests (by breaking the fee-for-service mold in favor of patient premium support), and more recently by its indirect support for the state’s acceptance in expanding Medicaid eligibility under the money-goes-to-the-institution model rather than the more efficient money-follow-the-patient paradigm.
The Gov. Bobby Jindal Administration, quite wisely, has rejected expansion under those terms, which would increase demand for medical services under the old, inefficient model, and the survey represented an attempt to demonstrate public support for expansion under those terms as well as away from the Bayou Health model, which theoretically if the Pres. Barack Obama Administration would show any flexibility on the expansion model to allow that model to be used would entice Jindal to accept. Perhaps to get the media to bite on publicizing the results, it also included approval measures for the Legislature and Jindal, as well as favorability ratings for him and Sens. Mary Landrieu and David Vitter, Lt. Gov. Jay Dardenne, and Treas. John Kennedy.
As far as the issues went, a plurality of the sample did not know of Bayou Health, but of those that did, a majority supported it. Barely more said the existing charity hospital system worked well prior to recent changes to move it away from government direct provision of health care than said those changes needed to be made, within the margin of error. It should not shock that Bayou Health is relatively unknown, nor despite the relative inefficiency of the charity system that it should hold up so well in opinion, as it would be surprising if even a tenth of Louisianans knew anything beyond the barest information about them, and the vast majority of that proportion would utilize these services or be providers of them. But it is interesting that among those with even minimal awareness of Bayou Health that it enjoyed relatively strong support.
The agenda also got mixed reviews regarding the rather misnamed Patient Protection and Affordable Care Act. While the sample lined up solidly against the whole of Obamacare, a small majority favored one of its constituent parts, the expansion. Again, neither result should surprise that much: while the public is largely aware of the various merits and demerits of the entire law that was the subject of massive discussion over two years, only a small segment understands the implications of acceptance or rejection of the expansion, and where knowledge is incomplete for many, populist instincts begin to kick in (all that “free” money up for grabs!).
As in the case of feelings about the charity system, it’s not so much a contradiction when understanding that the lack of information prompts falling back on populism that still remains a potent part of Louisiana’s political culture. But where things get really pertinent is in how these attitudes might get reflected in evaluations of leading political actors.
The most identified with all of these issues, given the authorship of his administration regarding, Bayou Health, reform to the charity system, opposition to expansion, and in outspokenness against Obamacare is Jindal. And while it’s hazardous to tie to opinion on health care matters to an evaluation of Jindal’s performance or approval, as fewer than 15 percent declared health care as the most important issue and fewer than 30 percent put it in their top three issues, Jindal came out of it all in a wash.
On the approval scale, Jindal registered a slight negative, 46-48, within the margin of error. On favorability, Jindal was slightly positive, the 49-46 gap also within the margin of error. Thus, despite an enormous amount of controversial reform efforts, much bucking strongly established interests and running against the populist impulse in the political culture, Jindal seems to be holding his own, after having much higher ratings at times where he did little risky policy-making beyond enforced budget reductions.
But perhaps more interestingly, on the favorability measure the figure running the highest was for the one most identified with the minority view on Obamacare, Landrieu at 59 percent, then followed by Vitter at 55 percent. Again, this indicates how ingrained populism proves confusing to a conservative mass public: with Landrieu being the key vote to have passed the entire package, yet she is not punished for it, at least in terms of likeability.
Note also that likeability translates poorly into reelection chances. Two years ago, right about the time Obamacare was in the final stages of being jackknifed into law, Landrieu’s favorability was only a little lower than it is now, yet of those who gave an opinion on the matter a majority answered they would not vote to reelect her regardless of opponent. And if there’s one thing you can count on in Louisiana politics, it’s if you do enough unpopular things, a quality opponent will expose you, and there’s every sign that the GOP is going to have one or more such candidates tie her Obamacare approval around her neck that will serve as an anchor very difficult to prevent her from sinking into retirement.
(As for the rest, the Legislature ranked 46-37 for approval, although it’s also debatable how much people generally really know about what it’s done lately, and while Kennedy ranked at and Dardenne just below Jindal’s favorability, their proportion of unfavorable mentions were much lower with even higher proportions than for the Legislature unwilling to rate them. Again, general lack of awareness of their records or even anything beyond recognizing their names means it’s tricky to read anything into this. Only Jindal, Landrieu, and Vitter had widespread name recognition.)
To sum up, Jindal has weathered the largest sea change in state political history decently, and Landrieu’s reelection chances are uncertain at best. But the public’s seemingly schizophrenic, even contradictory reactions to these issues and personalities among themselves shows populist emotions tug hard against conservative principles.